Vertical ramisection for prognathism.

Forty-four patients with Class III malocclusion, who were operated on for prognathism, have been reviewed. In spite of the associated problems of pain, nausea, fear, relapse, additional orthodontia, lip numbness, lip weakness, and 8 weeks with their teeth wired together, only one patient of the 44 said he (or she) would decline this surgery if it were to be considered anew. The surgeon must make a strong effort to keep the vertical cut in the bony ramus posterior to the lingula, to avoid postoperative lip numbness. He should also keep traction on the soft tissues minimal, to avoid postoperative weakness of the lower lip. A significant relapse was uncommon in this series, and the facial symmetry was greatly enhanced. Most of these 44 patients (66 percent) said the improvement in their self-image and personal appearance was far more important to them than the improvement in their bite.